25 Jan 2023

The guidelines, published last week by the Difficult Airway Society and the Association of Anaesthetists of Great Britain and Ireland, are designed to help NHS clinicians, anaesthesia departments and hospitals to improve safety in anaesthesia and reduce reliance on the exceptional performance of clinicians.  

The guidelines are designed to support the implementation of human factors principles into anaesthesia. Human factors are the characteristics of organisations, individuals, working environments, and jobs that influence behaviour in ways that can impact safety. Their importance in improving safety is paramount, and human factors training and applications have previously been used in nuclear power, transport, construction and the military.

Several years ago, the Difficult Airway Society and the Association of Anaesthetists established a multidisciplinary group including frontline clinicians, a human factors scientist, an industrial psychologist and an implementation scientist, Professor Nick Sevdalis of NIHR ARC South London, to develop the guidelines on implementing human factors principles into anaesthesia.

Professor Nick Sevdalis, who has worked in the field of perioperative patient safety improvement for almost 20 years, contributed implementation expertise to the guidelines. He said: "There is well-established evidence that mistakes and near-misses do occur perioperatively, especially in high-pressure situations."

By implementing systematically human factors principles the aim is to make it as easy as possible for anaesthetists and other perioperative care practitioners to do things correctly by ‘designing out’ the chance of an error occurring. Although applying human factors has the potential to improve safety, and we have known this for several years, its proper implementation needs to be planned and supported

Professor Nick Sevdalis

Professor Nick Sevdalis, professor of implementation science and patient safety, King's College London

Recommendations for improving safety  

The team formulated a set of 12 recommendations organised around how the work environment and anaesthetic equipment is designed, effective use of checklists before operating, encouraging staff of any seniority to speak up if they have safety concerns, ways to mitigate mistakes, and staff education and training. The aim of implementing these recommendations is to reduce stress in anaesthesia settings, helping to improve patient safety and the wellbeing of health professionals.

Find out more

The new national guidelines were published last week and will be implemented across all departments of anaesthesia in the NHS. The guideline is supported by a literature review in Anaesthesia.

View an infographic summarising the recommendations